Abstract

BackgroundIn plastic surgery, skin damage induced by ischemia/reperfusion (I/R) is a multifactorial process that often occurs. Methane gas has been reported to be a new therapeutic gas for attenuating I/R injury. In this study, we assessed the effects of methane-rich saline (MRS) in regulating apoptosis on skin flap I/R injury.MethodsMale Sprague–Dawley rats, 6–8 weeks old, were divided randomly into three groups: one sham surgery group (SH) and two surgery groups. After undergoing 6 h of I/R management of an abdominal skin flap, surgery groups were treated with physiological saline (I/R-P) or methane-rich saline (I/R-M). On the 3rd postoperative day, a laser Doppler flowmeter was used to measure flap blood supply, and hematoxylin and eosin (H&E) staining was used to observe morphological changes. TdT-mediated dUTP-X nick end labeling (TUNEL) staining was also used to observe early apoptosis and is presented as the percentage of TUNEL-positive cells. Moreover, pASK-1, pJNK, Bcl-2 and Bax were detected by immunohistochemical technology. Caspase-3 activity was also measured to evaluate the effects of MRS.ResultsCompared to the I/R-P group, the flaps in the I/R-M group presented a larger survival area and better blood perfusion with less inflammatory infiltration and cell apoptosis, a higher expression of Bcl-2, a lower expression of pASK-1, pJNK and Bax, and a lower caspase-3 activity.ConclusionAccording to the results, MRS attenuated I/R injury by regulating apoptosis and has the potential to be applied as a new therapy for improving skin flap survival.

Highlights

  • IntroductionSkin damage induced by ischemia/reperfusion (I/R) is a multifactorial process that often occurs

  • In plastic surgery, skin damage induced by ischemia/reperfusion (I/R) is a multifactorial process that often occurs

  • 18 qualified laboratory rats were randomly divided into 3 groups: a sham surgery group (SH); a 6-h ischemia group followed by physiological saline management (I/R-P); and a 6-h ischemia group followed by methane-rich saline (MRS) management (I/R-M)

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Summary

Introduction

Skin damage induced by ischemia/reperfusion (I/R) is a multifactorial process that often occurs. We assessed the effects of methane-rich saline (MRS) in regulating apoptosis on skin flap I/R injury. Skin flap transfer is a basic plastic surgery method used for wound repair and reconstruction. During I/R injury, many cytological and morphological changes like infiltration of neutrophils happen, among which apoptosis is one of the worst outcome. The infiltration of neutrophils brings more free radicals and exacerbates the flap injury [2]. According to Roccarina’s study, it is possible to detect intestinal methane with no specific clinical relevance among 1/3 of healthy adult individuals. He demonstrated that gas metabolism disorders and

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